光学相干断层扫描血管成像技术(OCTA)观察孔源性视网膜脱离复位术后黄斑区血流
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摘要
目的通过光学相干断层扫描血管成像技术(optical coherence tomography angiography,OCTA)观察孔源性视网膜脱离患者视网膜复位术后黄斑区血流情况。方法对单眼行孔源性视网膜脱离复位术患者进行术后随访。将患眼纳入试验组,将对侧健眼纳入对照组。在患者视网膜复位稳定6个月时使用OCTA对双眼黄斑区进行3 mm×3 mm大小成像,分别计算试验组与对照组浅层视网膜毛细血管(superficial capillary plexus,SCP)层黄斑中心凹无血流管区(foveal avascular zone,FAZ)面积、SCP层和深层视网膜毛细血管(deep capillary plexus,DCP)旁中心凹血流密度及中央视网膜厚度(central retinal thickness,CRT)。对比观察两组眼部血流参数信息,分别评估两组SCP层FAZ面积与CRT的相关性。结果本研究纳入21例单眼孔源性视网膜脱离复位术后患者。试验组SCP层旁中心凹血流密度为39. 50%±7. 10%,相比对照组的44. 11%±5. 72%更小(P=0. 026)。试验组CRT为(211. 95±30. 37)μm,相比对照组的(252. 38±15. 63)μm更薄(P <0. 001)。试验组SCP层FAZ面积、DCP层旁中心凹血流密度分别为(0. 34±0. 10) mm~2、47. 67%±9. 13%,与对照组的(0. 30±0. 01) mm~2、49. 70%±6. 10%相比,差异均无统计学意义(均为P> 0. 05)。两组SCP层FAZ面积与CRT均存在显著负相关(试验组:r=-0. 450,P=0. 041;对照组:r=-0. 527,P=0. 014)。结论孔源性视网膜脱离复位术后患眼黄斑区血流发生显著改变,OCTA观察视网膜脱离复位术后患眼血流有利于监测视网膜结构和功能变化。
Objective To investigate the characteristics of macular vessles after successful rhegmatogenous retinal detachment (RRD) repair with optical coherence tomography angiography (OCTA). Methods The patients who underwent RRD reattachment surgery with single eye were followed up. The affected eyes were included in the experimental group,and the contralateral healthy eyes were included in the control group. We covered a 3 mm × 3 mm area centered on the macular area with OCTA after 6 months of retina stably reattachment,and calculated the superficial foveal avascular zone (FAZ) area,the vessle density of the superficial retinal capillary plexuses (SCP) and the deep retinal capillary plexuses (DCP),and the central retinal thickness (CRT) in both experimental and control groups. We made a comparative observation of ocular blood flow parameters between the two groups. Evaluate the correlation between the superficail FAZ area and the CRT in the two groups separately. Results Total 21 patients who underwent RRD reattachment surgery with single eye were included in the study. The vessle density of the SCP were (39. 50% ± 7. 10%) in the experimental group,smaller than the control group[44.11% ± 5. 72% (P = 0. 026) ]. The CRT in the experimental group were (211. 95 ± 30. 37) μm,thinner than the control group (252. 38 ± 15. 63) μm (P < 0. 001). The superficail FAZ area and the vessel density of the DCP were (0. 34 ± 0. 10) mm~2 and 47. 67% ± 9. 13% respectively,no significant difference were detected when compared to the data in the control group[ (0. 30 ± 0.01) mm~2 and 49. 70% ± 6. 10% respectively] (P > 0. 05). There was a significant negative correlation between the superficial FAZ area and the CRT in both groups separately (the experimental group r =-0. 450,P = 0. 041; the control group r =-0. 527,P = 0. 014). Conclusion Macular vessles is obviously affected after retina reattachment surgery. Observing the blood flow of the affected eyes with OCTA is helpful to detect the changes of retinal structure and function afterretina reattachment.
Objective To investigate the characteristics of macular vessles after successful rhegmatogenous retinal detachment (RRD) repair with optical coherence tomography angiography (OCTA). Methods The patients who underwent RRD reattachment surgery with single eye were followed up. The affected eyes were included in the experimental group,and the contralateral healthy eyes were included in the control group. We covered a 3 mm × 3 mm area centered on the macular area with OCTA after 6 months of retina stably reattachment,and calculated the superficial foveal avascular zone (FAZ) area,the vessle density of the superficial retinal capillary plexuses (SCP) and the deep retinal capillary plexuses (DCP),and the central retinal thickness (CRT) in both experimental and control groups. We made a comparative observation of ocular blood flow parameters between the two groups. Evaluate the correlation between the superficail FAZ area and the CRT in the two groups separately. Results Total 21 patients who underwent RRD reattachment surgery with single eye were included in the study. The vessle density of the SCP were (39. 50% ± 7. 10%) in the experimental group,smaller than the control group[44.11% ± 5. 72% (P = 0. 026) ]. The CRT in the experimental group were (211. 95 ± 30. 37) μm,thinner than the control group (252. 38 ± 15. 63) μm (P < 0. 001). The superficail FAZ area and the vessel density of the DCP were (0. 34 ± 0. 10) mm~2 and 47. 67% ± 9. 13% respectively,no significant difference were detected when compared to the data in the control group[ (0. 30 ± 0.01) mm~2 and 49. 70% ± 6. 10% respectively] (P > 0. 05). There was a significant negative correlation between the superficial FAZ area and the CRT in both groups separately (the experimental group r =-0. 450,P = 0. 041; the control group r =-0. 527,P = 0. 014). Conclusion Macular vessles is obviously affected after retina reattachment surgery. Observing the blood flow of the affected eyes with OCTA is helpful to detect the changes of retinal structure and function afterretina reattachment.
引文
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[8]TENG Y,YU M,WANG Y,LIU X X,YOU Q S,LIU W,et al.OCTangiography quantifying choriocapillary circulation in idiopathic macular hole before and after surgery[J].Graefes Arch Clin Exp Ophthalmol,2017,255(5):893-902.
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[11]DELOLME M P,DUGAS B,NICOT F,MUSELIER A,BRON A,CREUZOT-GARCHER C.Anatomical and functional macular changes after rhegmatogenous retinal detachment with macula off[J].Am J Ophthalmol,2012,153(1):128-136.
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[14]SCHOCKET L S,WITKIN A J,FUJIMOTO J G,KO T H,SCHU-MAN J S,ROGERS A H,et al.Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair[J].Ophthalmology,2006,113(4):666-672.
[15]SHIMODA Y,SANO M,HASHIMOTO H,YOKOTA Y,KISHI S.Restoration of photoreceptor outer segment after vitrectomy for retinal detachment[J].Am J Ophthalmol,2010,149(2):284-290.
[16]KOBAYASHI M,IWASE T,YAMAMOTO K,RA E,MURO-TANI K,MATSUI S,et al.Association between photoreceptor regeneration and visual acuity following surgery for rhegmatogenous retinal detachment[J].Invest Ophthalmol Vis Sci,2016,57(3):889-898.
[17]SAMARA W A,SAY EA,KHOO C T,HIGGINS T P,MAGRATHG,FERENCZY S,et al.Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography[J].Retina,2015,35(11):2188-2195.
[18]LUPIDI M,COSCAS F,CAGINI C,FIORE T,SPACCINI E,FRUTTINI D,et al.Automated quantitative analysis of retinal microvasculature in normal eyes on optical coherence tomography angiography[J].Am J Ophthalmol,2016,169(9):9-23.
[19]TAN C S,LIM L W,CHOW V S,CHAY I W,TAN S,CHEONG KX,et al.Optical coherence tomography angiography evaluation of the parafoveal vasculature and its relationship with ocular factors[J].Invest Ophthalmol Vis Sci,2016,57(9):1224-1234.
[20]SATO T,KANAI M,BUSCH C,WAKABAYASHI T.Foveal avascular zone area after macula-off rhegmatogenous retinal detachment repair:an optical coherence tomography angiography study[J].Graefes Arch Clin Exp Ophthalmol,2017,255(10):2071-2072.
[21]WOO J M,YOON Y S,WOO J E,MIN J K.Foveal avascular zone area changes analyzed using OCT angiography after successful rhegmatogenous retinal detachment repair[J].Curr Eye Res,2018,43(5):674-678.
[22]JIAO Y,FU B B,YE B,HUANG Y H,ZHANG H,HE W S,et al.Clinical observation of optical coherence tomography angiography in the macular vascular density after repair of retinal detachment[J].Rec Adv Ophthalmol,2018,38(4):373-377.焦亚,付碧波,叶波,黄银花,章晖,贺文山,等.视网膜脱离复位术后黄斑区血流密度:基于光学相干断层扫描血管成像(OCTA)的观察[J].眼科新进展,2018,38(4):373-377.
[2]IWASE T,KOBAYASHI M,YAMAMOTO K,YANAGIDA K,RAE,TERASAKI H.Changes in blood flow on optic nerve head after vitrectomy for rhegmatogenous retinal detachment[J].Invest Ophthalmol Vis Sci,2016,57(14):6223-6233.
[3]SPAIDE R F,KLANCNIK J J,COONEY M J.Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography[J].JAMA Ophthalmol,2015,133(1):45-50.
[4]TRIOLO G,RABIOLO A,SHEMONSKI N D,FARD A,DI M,SAC-CONI R,et al.Optical coherence tomography angiography macular and peripapillary vessel perfusion density in healthy subjects,glaucoma suspects,and glaucoma patients[J].Invest Ophthalmol Vis Sci,2017,58(13):5713-5722.
[5]YU J,GU R,ZONG Y,XU H,WANG X,SUN X,et al.Relationship between retinal perfusion and retinal thickness in healthy subjects:an optical coherence tomography angiography study[J].Invest Ophthalmol Vis Sci,2016,57(9):204-210.
[6]YU J,JIANG C,WANG X,ZHU L,GU R,XU H,et al.Macular perfusion in healthy Chinese:an optical coherence tomography angiogram study[J].Invest Ophthalmol Vis Sci,2015,56(5):3212-3217.
[7]MCCLINTIC S M,JIA Y,HUANG D,BAILEY S.Optical coherence tomographic angiography of choroidal neovascularization associated with central serous chorioretinopathy[J].JAMA Ophthalmol,2015,133(10):1212.
[8]TENG Y,YU M,WANG Y,LIU X X,YOU Q S,LIU W,et al.OCTangiography quantifying choriocapillary circulation in idiopathic macular hole before and after surgery[J].Graefes Arch Clin Exp Ophthalmol,2017,255(5):893-902.
[9]JIA Y,WEI E,WANG X,ZHANG X B,MORRISON J,PARIKHM,et al.Optical coherence tomography angiography of optic disc perfusion in glaucoma[J].Ophthalmology,2014,121(7):1322-1332.
[10]JIA Y,TAN O,TOKAYER J,POTSAID B,WANG Y,LIU JJ,et al.Split-spectrum amplitude-decorrelation angiography with optical coherence tomography[J].Opt Express,2012,20(4):4710-4725.
[11]DELOLME M P,DUGAS B,NICOT F,MUSELIER A,BRON A,CREUZOT-GARCHER C.Anatomical and functional macular changes after rhegmatogenous retinal detachment with macula off[J].Am J Ophthalmol,2012,153(1):128-136.
[12]ADHI M,DUKER J S.Optical coherence tomography--current and future applications[J].Curr Opin Ophthalmol,2013,24(3):213-221.
[13]GHARBIYA M,GRANDINETTI F,SCAVELLA V,CECERE M,ESPOSITO M,SEGNALINI A,et al.Correlation between spectraldomain optical coherence tomography findings and visual outcome after primary rhegmatogenous retinal detachment repair[J].Retina,2012,32(1):43-53.
[14]SCHOCKET L S,WITKIN A J,FUJIMOTO J G,KO T H,SCHU-MAN J S,ROGERS A H,et al.Ultrahigh-resolution optical coherence tomography in patients with decreased visual acuity after retinal detachment repair[J].Ophthalmology,2006,113(4):666-672.
[15]SHIMODA Y,SANO M,HASHIMOTO H,YOKOTA Y,KISHI S.Restoration of photoreceptor outer segment after vitrectomy for retinal detachment[J].Am J Ophthalmol,2010,149(2):284-290.
[16]KOBAYASHI M,IWASE T,YAMAMOTO K,RA E,MURO-TANI K,MATSUI S,et al.Association between photoreceptor regeneration and visual acuity following surgery for rhegmatogenous retinal detachment[J].Invest Ophthalmol Vis Sci,2016,57(3):889-898.
[17]SAMARA W A,SAY EA,KHOO C T,HIGGINS T P,MAGRATHG,FERENCZY S,et al.Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography[J].Retina,2015,35(11):2188-2195.
[18]LUPIDI M,COSCAS F,CAGINI C,FIORE T,SPACCINI E,FRUTTINI D,et al.Automated quantitative analysis of retinal microvasculature in normal eyes on optical coherence tomography angiography[J].Am J Ophthalmol,2016,169(9):9-23.
[19]TAN C S,LIM L W,CHOW V S,CHAY I W,TAN S,CHEONG KX,et al.Optical coherence tomography angiography evaluation of the parafoveal vasculature and its relationship with ocular factors[J].Invest Ophthalmol Vis Sci,2016,57(9):1224-1234.
[20]SATO T,KANAI M,BUSCH C,WAKABAYASHI T.Foveal avascular zone area after macula-off rhegmatogenous retinal detachment repair:an optical coherence tomography angiography study[J].Graefes Arch Clin Exp Ophthalmol,2017,255(10):2071-2072.
[21]WOO J M,YOON Y S,WOO J E,MIN J K.Foveal avascular zone area changes analyzed using OCT angiography after successful rhegmatogenous retinal detachment repair[J].Curr Eye Res,2018,43(5):674-678.
[22]JIAO Y,FU B B,YE B,HUANG Y H,ZHANG H,HE W S,et al.Clinical observation of optical coherence tomography angiography in the macular vascular density after repair of retinal detachment[J].Rec Adv Ophthalmol,2018,38(4):373-377.焦亚,付碧波,叶波,黄银花,章晖,贺文山,等.视网膜脱离复位术后黄斑区血流密度:基于光学相干断层扫描血管成像(OCTA)的观察[J].眼科新进展,2018,38(4):373-377.